RESUMEN
The migration of Kirschner wires (K-wires) is a rare complication. We herein present a case of an inflammatory polyp in the colon caused by the migration of a K-wire following fixation of a pelvic fracture. Surgery was carried out to remove the K-wire through an incision at the level of the left iliac bone. Simultaneous endoscopic clipping of the colonic wound was also performed. The patient's postoperative course was uneventful. Although very rare, migration of devices should be considered in patients with a previous history of orthopedic surgery.
Asunto(s)
Hilos Ortopédicos/efectos adversos , Colon/lesiones , Pólipos del Colon/etiología , Migración de Cuerpo Extraño/complicaciones , Fijación Interna de Fracturas/efectos adversos , Fracturas Óseas/cirugía , Huesos Pélvicos/lesiones , Colon/cirugía , Pólipos del Colon/diagnóstico , Pólipos del Colon/cirugía , Colonoscopía , Remoción de Dispositivos/métodos , Migración de Cuerpo Extraño/diagnóstico , Fijación Interna de Fracturas/instrumentación , Fracturas Óseas/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Huesos Pélvicos/diagnóstico por imagen , Tomografía Computarizada por Rayos XAsunto(s)
Carcinoma Ductal Pancreático/complicaciones , Neoplasias Pancreáticas/complicaciones , Infarto del Bazo/diagnóstico , Infarto del Bazo/etiología , Anciano , Carcinoma Ductal Pancreático/patología , Progresión de la Enfermedad , Resultado Fatal , Hemorragia Gastrointestinal/etiología , Humanos , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/secundario , Masculino , Neoplasias Pancreáticas/patologíaRESUMEN
AIM: To investigate the different impact of genotypes B and C on the development of liver cirrhosis (LC) among different age groups of patients with chronic hepatitis B (CH-B). METHODS: We examined the outcome of 121 patients with CH-B, divided by age and genotype. Univariate analyses were used to compare different groups. The Cox proportional hazard model was employed to evaluate factors affecting the development of LC. RESULTS: In patients < 30 years old, there were no significant predictors for development of LC. However, in patients > or = 30 years old, genotype C was the only significant predictor. In the genotype C group, 8 of 12 patients who progressed to LC were 30-49 years old at initial diagnosis of chronic hepatitis (7 patients were positive for HBeAg). In the genotype B group, 4 of 8 patients who developed LC were > or = 50 years old at initial diagnosis and were HBeAg-negative. CONCLUSION: The rate of development of LC was comparable in patients infected with genotypes B and C when CH-B occurred at < 30 years old. However, CH-B patients infected with genotype C showed poor prognosis if they were 30-49 years old and were positive for HBeAg. Age-specific natural course of CH-B should be considered when patients with CH-B are treated with antiviral drugs.
Asunto(s)
Envejecimiento , ADN Viral , Virus de la Hepatitis B/genética , Hepatitis B Crónica/complicaciones , Cirrosis Hepática/virología , Adulto , Distribución por Edad , Factores de Edad , Anciano , Progresión de la Enfermedad , Genotipo , Antígenos e de la Hepatitis B/sangre , Hepatitis B Crónica/diagnóstico , Hepatitis B Crónica/genética , Hepatitis B Crónica/inmunología , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
AIM: Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), and progresses to the end stage of liver disease. Biochemical markers of liver fibrosis are strongly associated with the degree of histological liver fibrosis in patients with chronic liver disease. However, data are few on the usefulness of markers in NAFLD patients. The aim of this study was to identify better noninvasive predictors of hepatic fibrosis, with special focus on markers of liver fibrosis, type VI collagen 7S domain and hyaluronic acid. METHODS: One hundred and twelve patients with histologically proven NAFLD were studied. RESULTS: The histological stage of NAFLD correlated with several clinical and biochemical variables, the extent of hepatic fibrosis and the markers of liver fibrosis were relatively strong associated. The best cutoff values to detect NASH were assessed by using receiver operating characteristic analysis: type VI collagen 7S domain > or =5.0 ng/mL, hyaluronic acid > or =43 ng/mL. Both markers had a high positive predictive value: type VI collagen 7S domain, 86% and hyaluronic acid, 92%. Diagnostic accuracies of these markers were evaluated to detect severe fibrosis. Both markers showed high negative predictive values: type VI collagen 7S domain (> or =5.0 ng/mL), 84% and hyaluronic acid (> or =50 ng/mL), 78%, and were significantly and independently associated with the presence of NASH or severe fibrosis by logistic regression analysis. CONCLUSION: Both markers of liver fibrosis are useful in discriminating NASH from fatty liver alone or patients with severe fibrosis from patients with non-severe fibrosis.